Learning phacoemulsification: The surgeon-in-training

With the increasing trend towards phacoemulsification a perceived increased complication rate during the learning curve gives rise to a dilemma as to the best stage at which a surgeon-in-training can safely learn the technique. We prospectively analysed the complications and visual outcome of the first 160 phacoemulsification procedures performed by three surgeons-in-training. The main outcome measures included posterior capsule tear, vitreous and nuclear loss, surgical re-intervention rate and visual outcome. Posterior capsule tear occurred in 7 eyes (4.4%) and vitreous loss in 6 (3.8%). No nucleus was lost in the vitreous. Surgical re-intervention was required in 1 eye. Best corrected visual acuity was 6/12 or better in 88% of eyes. These results compare favourably with reports of surgeons-in-training learning extracapsular surgery and also with recently reported phacoemulsification series. This study indicates that with careful case selection and supervision phacoemulsification can be a safe procedure.